| NPI | 1184678328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA029969) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 1184831) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2013-07-08 |