| NPI | 1447220306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TN 0000017271) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 17271) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2017-12-12 |