| NPI | 1619915717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G70675) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA G70675) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-07-09 |