| NPI | 1275629297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: FL ME76562) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: NJ MA56315) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-08-05 |