| NPI | 1689981565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2015020054) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-056805) |
| 208000000X Pediatrics (Licence: MO 2015020054) | |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2016-08-31 |