| NPI | 1801872916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 60217) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MA 60217) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2012-06-07 |