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 |