| NPI | 1003071945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME108763) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD 0071739) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2019-10-09 |