| NPI | 1730195900 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MI 4301046871) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301046871) | 
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 4301046871) | |
| Enumeration Date | 2006-07-31 | 
| Last Update Date | 2012-09-17 |