| NPI | 1760415384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NJ 25MA10557500) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 2288751) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 228875) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2023-06-18 |