| NPI | 1477519502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NJ 25MA08255000) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08255000) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 178371-1) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD039488E) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2024-05-02 |