| NPI | 1588184105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: UT 11734162-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-071276) |
| Enumeration Date | 2017-06-24 |
| Last Update Date | 2020-06-03 |