| NPI | 1942392774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA07515700) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: DE C10006688) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: DE C10006688) | |
| 208D00000X General Practice (Licence: DE C10006688) | |
| 208M00000X Hospitalist (Licence: DE C10006688) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2017-09-27 |