| NPI | 1821174772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NJ 25MA12296500) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 212630) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NY 212630) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2025-06-04 |