| NPI | 1306068507 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 57.009103)  | 
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME98904)  | 
| Enumeration Date | 2007-05-03 | 
| Last Update Date | 2018-03-26 |