| NPI | 1861689226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME101655) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301082269) |
| 208000000X Pediatrics (Licence: FL ME101655) | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2008-10-31 |