NPI | 1326365982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NJ 25MA09965700) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD449408) |
Enumeration Date | 2010-04-22 |
Last Update Date | 2018-05-31 |