| NPI | 1043286339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME105947) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD067978L) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2012-04-11 |