| NPI | 1164535852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OR or md13494) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WA wa md00023948) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2011-08-12 |