| NPI | 1063443240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.068202) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.068202) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2015-05-14 |