NPI | 1891058178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MA 262683) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 253216) |
Enumeration Date | 2012-06-21 |
Last Update Date | 2018-05-01 |