| 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 |