NPI | 1104862655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX E5270) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX E5270) |
Enumeration Date | 2006-06-22 |
Last Update Date | 2008-02-12 |