| NPI | 1871089409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD479327) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301507527) |
| 208000000X Pediatrics (Licence: IA R-11716) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 4301507527) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IA R-11716) | |
| 208D00000X General Practice (Licence: IA MD-49686) | |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2024-01-31 |