| NPI | 1619920816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: CA A49253) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: CA A49253) |
| 208M00000X Hospitalist (Licence: CA A49253) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-06-03 |