| NPI | 1740441948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: GA 76961) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301091443) |
| 208000000X Pediatrics (Licence: WI 54955) | |
| 208000000X Pediatrics (Licence: GA 76961) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2017-03-01 |