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 |