| NPI | 1164591798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101227934) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: LA MD.201795) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL 115952) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2013-09-23 |