| NPI | 1568417350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101042554) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101042554) |
| 208000000X Pediatrics (Licence: VA 0101042554) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2009-12-09 |