| NPI | 1801162557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX S2171) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.128165) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2020-04-21 |