| NPI | 1942288360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MD D0066475) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD049687L) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2011-04-29 |