| NPI | 1235422171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NJ 25mb09533400) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 269909) | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2016-12-09 |