| NPI | 1215298369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 289631) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 289631) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2022-09-06 |