| NPI | 1760042352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: IA MD-49851) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-11678) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2022-04-21 |