| NPI | 1720040504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NM MD2020-0382) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: AZ 66241) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2025-07-24 |