| NPI | 1265759252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD454177) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA09667200) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2018-11-27 |