| NPI | 1588784482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101039528) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: VA 0101039528) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2009-12-23 |