| NPI | 1972540060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: GA 054989) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 54989) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX R6358) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2019-02-27 |