| NPI | 1427006691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA08043700) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD067607L) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-12-05 |