NPI | 1194214726 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 310116) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 310116) |
Enumeration Date | 2018-05-09 |
Last Update Date | 2023-11-17 |