| NPI | 1124006473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX N4757) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101236333) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2017-12-20 |