| NPI | 1750485959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2005-00509) |
| Additional Taxonomies | 174400000X Specialist (Licence: 074963) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2019-03-28 |