| NPI | 1770838757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX V0259) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 53798) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MS 26092) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2025-03-12 |