| NPI | 1184681025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 50935) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VI 1097) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME113567) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2018-04-24 |