NPI | 1689640393 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NJ 25MA07170500) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA07170500) |
Enumeration Date | 2006-02-23 |
Last Update Date | 2024-05-24 |