| NPI | 1174718035 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NJ 25MA08935900)  | 
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD431091)  | 
| 208000000X Pediatrics (Licence: PA MD431091)  | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD431091)  | |
| Enumeration Date | 2007-09-12 | 
| Last Update Date | 2011-08-18 |