| NPI | 1578534210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NJ 25MA08022100) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 203179) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2025-09-11 |