| NPI | 1417923418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: NY 211515) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 211515-1) |
| 208000000X Pediatrics (Licence: NY 211515-1) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2023-06-09 |