| NPI | 1679716799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: LA MD.205325) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R2499) |
| 208000000X Pediatrics (Licence: LA MD.205325) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX R2499) | |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2023-03-15 |