| NPI | 1801096870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: PA MD430014) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD430014) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2013-04-17 |