| NPI | 1164508297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 191796) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NY 191796) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2007-00787) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2008-11-17 |