| NPI | 1164691937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: SC MD35496) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO AS3835571-2007017363) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2013-07-07 |