| NPI | 1063500817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2008-00507) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: SC 25483) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2011-08-05 |