| NPI | 1962609156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD439232) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT190291) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2013-07-09 |