| NPI | 1669792255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX N6662) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N6662) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2024-04-03 |