NPI | 1619119286 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 310668) |
Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: GU M-1756) |
2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: UT 7279072-1205) | |
Enumeration Date | 2009-03-29 |
Last Update Date | 2021-12-01 |