| NPI | 1437136199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 15106) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 15106) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2020-04-09 |