| NPI | 1962768960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA10370000) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 278695) |
| 2080S0012X Pediatrics, Sleep Medicine (Licence: NJ 25MA10370000) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2018-08-10 |