| NPI | 1780788117 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101017970) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101017970) | 
| Enumeration Date | 2006-09-07 | 
| Last Update Date | 2025-09-11 |