| NPI | 1770891665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 271701) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 125057014) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2026-05-07 |