| NPI | 1699891374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: UT 14196340-1234) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: ID O-1943) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2026-05-22 |