| NPI | 1679523427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MT 11812) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MT 11812) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2009-05-27 |