| NPI | 1972675676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: MI 4301045923) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301045923) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2012-07-16 |