| NPI | 1861429987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OR MD29018) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD29018) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2015-01-12 |