NPI | 1972908978 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME148702) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2016-02070) |
2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2016-02070) | |
Enumeration Date | 2014-11-03 |
Last Update Date | 2021-09-30 |