| NPI | 1932337144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD444389) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT195646) |
| 208000000X Pediatrics (Licence: NJ 25MA09115100) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2016-04-25 |