| NPI | 1891716510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX M6080) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: LA 022225) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX M6080) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2013-03-08 |