| NPI | 1316908171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 167729) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 167729) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2018-03-17 |