| NPI | 1659483832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: OR MD22228) |
| Additional Taxonomies | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: WA MD00038145) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-02-06 |