| NPI | 1982059242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 101160) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0103067) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D0103067) | |
| 208000000X Pediatrics (Licence: CA A201490) | |
| 208000000X Pediatrics (Licence: OH 35C.001714) | |
| 208000000X Pediatrics (Licence: MI 4301119065) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 4301119065) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35C.001714) | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2026-02-05 |