| NPI | 1730251174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MA 265610) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 32679) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2016-10-10 |