| NPI | 1003857798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101050297) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: VA 0101050297) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101050297) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2010-02-10 |