| NPI | 1679522189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MD434698) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD434698) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NJ 25MA07766200) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2013-05-21 |