| NPI | 1598099632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AR E-6275) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08563700) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2010-01-08 |