| NPI | 1669039335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 4301506589) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.074134) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2025-07-25 |