| NPI | 1912349861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.150275) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 6696320) |
| Enumeration Date | 2013-07-20 |
| Last Update Date | 2024-03-06 |