NPI | 1033150099 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NJ 25MA07954800) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA07954800) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2025-01-02 |