| NPI | 1790707909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D43490) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D43490) |
| 208D00000X General Practice (Licence: MD D43490) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-05-27 |