| NPI | 1972587673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: RI MD10402) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI MD10402) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MA 219814) | |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2021-05-04 |