| NPI | 1497739791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D0052219) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0052219) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-09 |