| NPI | 1821383407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: WI 67516-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD P26382) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2018-03-17 |