| NPI | 1821202508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME101887) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301082877) |
| 208000000X Pediatrics (Licence: FL ME101887) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2008-10-30 |