| NPI | 1659378008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NM MD2009-0599) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CT 043312) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2013-05-23 |