| NPI | 1194780536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MA 209923) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 209923) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2016-03-01 |