| NPI | 1063540284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: AZ 44817) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 127106) |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: PA MD433623) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2011-07-26 |