| NPI | 1700412731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NJ 25MA13034800) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD485215) |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2026-06-19 |