| NPI | 1770746406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CT 053366) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-055387) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2014-09-08 |