| NPI | 1578539300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: MO 2016008702) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2016008702) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2024-04-25 |