| NPI | 1760695050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0101245443) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD035915) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D0064575) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2016-03-11 |