| NPI | 1205842408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ MA63115) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NJ 063115) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NJ MA63115) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2009-09-01 |