| NPI | 1174586739 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NJ 25MA08531200)  | 
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD419642)  | 
| Enumeration Date | 2006-04-06 | 
| Last Update Date | 2014-05-01 |