| NPI | 1871088054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN T2404) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0116032091) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2024-07-03 |