| NPI | 1699836858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL 93728) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0048175) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2025-09-11 |