NPI | 1811483811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: KS 94-09617) |
Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: IL 036.168969) |
2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME174110) | |
Enumeration Date | 2018-07-03 |
Last Update Date | 2025-10-08 |