NPI | 1063573111 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: NY 151386) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 151386) |
207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 151386) | |
Enumeration Date | 2006-12-13 |
Last Update Date | 2025-09-11 |