NPI | 1639377864 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX U3932) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD440526) |
208000000X Pediatrics (Licence: PA MT190455) | |
Enumeration Date | 2007-07-10 |
Last Update Date | 2024-04-16 |