| NPI | 1043623762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 310548) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: AZ 66034) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2023-10-20 |