| NPI | 1790731230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 200200707) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200200707) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2008-09-02 |