| NPI | 1528371176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NE 29133) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.122082) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2016-04-01 |