| NPI | 1942263173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: CO 21128) |
| Additional Taxonomies | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: WA MD00013043) |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: CA G19735) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2011-05-26 |