| NPI | 1730126533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MB06989100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MB69891) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2011-05-26 |