| NPI | 1699980847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: MN 64720) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ND 11824) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2019-03-01 |