| NPI | 1265473011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN MD49194) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D47935) |
| 208000000X Pediatrics (Licence: MD D47935) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2013-01-14 |