| NPI | 1417976986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 194992) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 194992) |
| 208000000X Pediatrics (Licence: MO 2009009261) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2009009261) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-02-27 |