| NPI | 1891757431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX L8507) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA G38371) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: ND 5057) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2007-07-08 |