| NPI | 1730564287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2023050212) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A152666) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2024-08-20 |