| NPI | 1699962993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME148367) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A96611) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2021-02-28 |