| NPI | 1700226859 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101257524) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD G-616-067-398-042) | 
| Enumeration Date | 2013-07-02 | 
| Last Update Date | 2023-08-10 |