| NPI | 1316173214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 003337) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 003337) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 003337) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2012-03-08 |