| NPI | 1013101724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2014021551) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 38931) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KS 04-40202) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2017-09-05 |