| NPI | 1104280783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 320489) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NV DO2605) |
| 208000000X Pediatrics (Licence: NV DO2605) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2024-02-29 |