| NPI | 1154777449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NJ 2080N0001X) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA09900200) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2026-08-12 |