| NPI | 1881636801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN MD53872) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D63461) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D63461) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2022-03-23 |