| NPI | 1992884225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 158133) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 158133) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2011-04-20 |