| NPI | 1275719445 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: UT 7590021-1205)  | 
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.088644)  | 
| Enumeration Date | 2008-01-17 | 
| Last Update Date | 2010-10-19 |