| NPI | 1396918173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN 47594) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 47594) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2015-09-02 |