| NPI | 1467406561 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101045119)  | 
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101045119)  | 
| Enumeration Date | 2006-05-22 | 
| Last Update Date | 2009-12-09 |