| NPI | 1811551013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 77140-21) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 77140-21) |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2024-03-08 |