| NPI | 1649360645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 4301111677) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 27575) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2022-10-05 |