| NPI | 1225486905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NJ 25MA10631300) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ S94800710005902) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2019-09-03 |