| NPI | 1306909189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: FL ME86359) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NC 2005-01166) |
| 208000000X Pediatrics (Licence: NC 2005-01166) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2013-02-13 |