| NPI | 1841303427 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX E1877) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX E1877) | 
| Enumeration Date | 2006-08-16 | 
| Last Update Date | 2008-11-17 |