| NPI | 1124241708 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: GA 058824) | 
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IN 01066577) | 
| Enumeration Date | 2007-04-11 | 
| Last Update Date | 2014-09-19 |