| NPI | 1982680997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OR MD22117) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD22117) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OR MD22117) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2022-07-21 |