| NPI | 1659690717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 73228) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 73228) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MS 25149) | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2021-06-15 |