| NPI | 1346626132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 285183) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 285183) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2021-04-23 |