| NPI | 1912016601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OR OR DO24246) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WA WA OP00001840) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA 20A7247) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2022-02-04 |