| NPI | 1063476224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX G7314) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX G7314) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2007-07-12 |