| NPI | 1952404998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2012012808) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD16593) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2023-03-07 |