| NPI | 1225260490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09210400) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA09210400) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2023-06-09 |