| NPI | 1740360890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 4301081891) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 37207) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2021-01-04 |