| NPI | 1215053582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NV 14287) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301093717) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2018-09-07 |