| NPI | 1831152479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN 025669) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 2826) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 26634) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2025-10-17 |