NPI | 1760616411 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME118770) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A107588) |
Enumeration Date | 2009-05-11 |
Last Update Date | 2018-03-29 |