| NPI | 1871568733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME104995) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 38049) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2023-01-31 |