| NPI | 1689938193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 67214) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2015008275) |
| 208000000X Pediatrics (Licence: MO 2015008275) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2020-04-20 |