| NPI | 1508872631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NJ 25ma08446300) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI MD11817) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2009-09-11 |