| NPI | 1750588653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: MA 264954) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD040645) |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: DC MD040645) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2015-10-26 |