NPI | 1790784775 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CO 30059) |
Additional Taxonomies | 174400000X Specialist (Licence: LA 10319R) |
Enumeration Date | 2005-07-20 |
Last Update Date | 2011-04-04 |