| NPI | 1669577839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: MO R4N04) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO R4N04) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2021-01-28 |