| NPI | 1427149327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD429937) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08140100) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2018-12-02 |