| NPI | 1861691982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: LA MD.202778) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD434374) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2010-11-10 |