| NPI | 1679785570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 34.010569) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101017072) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 5101017072) | |
| 208000000X Pediatrics (Licence: OH 34.010569) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2014-10-31 |