| NPI | 1790064913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A117143) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A117143) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: ND 15797) | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2023-12-28 |