| NPI | 1174567630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 9500725) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 9500725) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-07-09 |