| NPI | 1831327360 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX Q3753) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 003993) | 
| 208000000X Pediatrics (Licence: FL ME112378) | |
| 208000000X Pediatrics (Licence: SC LL32374) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME112378) | |
| Enumeration Date | 2009-06-23 | 
| Last Update Date | 2015-08-17 |