| NPI | 1497732093 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: NV 6413) | 
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NV 6413) | 
| Enumeration Date | 2005-12-27 | 
| Last Update Date | 2018-03-17 |