| NPI | 1053324913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 002564) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 002564) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 002564) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2021-08-17 |