| NPI | 1356679005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX N5574) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08266600) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2021-01-04 |