| NPI | 1184791220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN 58490) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 39020000X) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2019-05-02 |