| NPI | 1962500983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: NJ MA59353) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD-021268-E) |
| 208000000X Pediatrics (Licence: NJ MA59353) | |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: PA MD-021268-E) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2016-04-25 |