NPI | 1750436853 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: DC 10770) |
Additional Taxonomies | 208000000X Pediatrics (Licence: DC 10770) |
Enumeration Date | 2007-01-25 |
Last Update Date | 2025-09-11 |