| NPI | 1114290996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NJ 25MA09120400) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA09120400) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2023-06-16 |