| NPI | 1780831867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NJ MA08536500) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD438297) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 246038) | |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2022-02-01 |