| NPI | 1770568172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 200300181) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2003-000181) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CT 56121) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: ND 14323) | |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2022-04-28 |