| NPI | 1316151376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: WI 53241) |
| Additional Taxonomies | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: CA A90436) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2014-03-26 |