| NPI | 1659508992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: IA MD-42627) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10035460) |
| Enumeration Date | 2009-06-13 |
| Last Update Date | 2015-08-28 |