| NPI | 1023081791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2006025325) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 42035) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KS 04-34019) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2018-03-17 |