| NPI | 1669645727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX P0307) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2005019116) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2010011926) | |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2011-08-03 |