| NPI | 1962446328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: LA 331297) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 331297) |
| 208000000X Pediatrics (Licence: FL ME120657) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D85280) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME120657) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2023-10-10 |