| NPI | 1972824605 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA A118384)  | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2010017376)  | 
| Enumeration Date | 2010-06-16 | 
| Last Update Date | 2024-03-05 |