| NPI | 1265513352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NE 25664) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN 7898) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-06-25 |