| NPI | 1720192636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2008-00256) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2008-00256) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2014-12-23 |