| NPI | 1720475296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A188159) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101264617) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2023-10-10 |