| NPI | 1265410369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: AZ 44078) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM MD2004-0209) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2013-05-22 |