NPI | 1649243684 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NJ 25MA04393300) |
Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD070806L) |
2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 136169) | |
Enumeration Date | 2006-02-09 |
Last Update Date | 2019-11-11 |