| NPI | 1639120116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD056173L) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NJ 25MA05936400) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2018-11-28 |