| NPI | 1083704159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: GA 068983) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL29238) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.094111) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2013-08-16 |