| NPI | 1639737943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MT218019) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT218019) |
| Enumeration Date | 2019-06-01 |
| Last Update Date | 2021-07-13 |