| NPI | 1760776769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN 57150) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: GA 74421) |
| 208000000X Pediatrics (Licence: SC LL33534) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2018-10-10 |