| NPI | 1407818388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MN 56013) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: HI 12652) |
| 208000000X Pediatrics (Licence: MN 56013) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2013-04-24 |