| NPI | 1013910488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25IA12675800) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CT 1.062625) |
| 207P00000X Emergency Medicine (Licence: NY 271158) | |
| 208000000X Pediatrics (Licence: FL ME0054065) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: GA 71590) | |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 271158) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2025-10-14 |