| NPI | 1093031114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 307581) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NJ 25MA09124600) |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2017-12-12 |