| NPI | 1164488656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 217311) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 217311) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2021-04-26 |