| NPI | 1720055619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: ID M-15590) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60458701) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WA MD60458701) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2024-04-26 |