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 |