| NPI | 1689617094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: FL ME 80566) |
| Additional Taxonomies | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: SC 26889) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-07-08 |