| NPI | 1891820627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A50421) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A50421) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2022-07-21 |