| NPI | 1902945900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NM MD2007-0088) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM 2004-421) |
| 208000000X Pediatrics (Licence: NM MD2007-0088) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2016-12-06 |