| NPI | 1780973479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 1796) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA DO-04562) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IA DO-04562) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2022-10-26 |