| 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 |