| NPI | 1841392792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: AZ 32487) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 60 239629) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2025-07-10 |