| NPI | 1326288010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NM MD2011-0818) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 42358) |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2011-12-15 |