NPI | 1235162017 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 166628) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 166628) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2007-10-23 |