| NPI | 1922022334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D38718) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D38718) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-07-13 |