NPI | 1548346398 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NJ 25MA08400600) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 235757) |
Enumeration Date | 2006-10-27 |
Last Update Date | 2010-05-11 |