| NPI | 1457529299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA08344700) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NJ 25MA08344700) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2025-05-31 |