| NPI | 1710370440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA11878500) |
| Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: CA 134300) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA A134300) | |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2024-02-05 |