| NPI | 1760988711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25IA12208700) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NJ 25IA12208700) |
| 208000000X Pediatrics (Licence: GA 87865) | |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2024-10-09 |