| NPI | 1013953579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D75544) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L5956) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX L5956) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2018-05-18 |