| NPI | 1326074030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA07661900) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NJ 25MA07661900) |
| 208000000X Pediatrics (Licence: NJ 25MA07661900) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2022-05-31 |