| NPI | 1518312412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NJ 25IA12819900) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25IA12819900) |
| 208000000X Pediatrics (Licence: AL MD.36643) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2025-09-17 |