| NPI | 1841795044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: NJ 25MA12619200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA12619200) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-05-14 |