| NPI | 1992791875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35046225) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 23482) |
| 208000000X Pediatrics (Licence: KY 23482) | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 23482) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2010-07-14 |