| NPI | 1376631002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: AZ 58196) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 087449) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-12-10 |