| NPI | 1699335232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA OS022334) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT019422) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2025-07-24 |