| NPI | 1326063058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 207490-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX M0122) |
| 174400000X Specialist (Licence: NY 207490) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2017-01-24 |