| NPI | 1154535847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.092027) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301086440) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2011-09-01 |