| NPI | 1881662401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA07071700) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA7071700) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2025-07-02 |