| NPI | 1508810797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO MD R4N97) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KS 04-23551) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2007-07-30 |