| NPI | 1750436853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DC 10770) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: DC 10770) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-07-08 |