| NPI | 1881149540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA10600800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10600800) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2023-08-10 |