| NPI | 1356505689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 44365) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301091859) |
| 208000000X Pediatrics (Licence: IN 01075049A) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2017-07-25 |