| NPI | 1881604601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 216275) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2006034636) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2006034636) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2023-09-13 |