| NPI | 1659589323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 51659) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57009712) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2024-03-01 |