| NPI | 1881779684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA 38276) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CO 42848) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2009-06-24 |