| NPI | 1871769786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.122999) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.122999) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2014-07-08 |