| NPI | 1164489423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NH LT-3609) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MA 54694) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2015-12-01 |