NPI | 1912961152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: WA OP60652225) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX J6639) |
Enumeration Date | 2006-04-14 |
Last Update Date | 2022-01-24 |