| NPI | 1427586924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 304901) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 304901) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-27 |
| Last Update Date | 2023-05-04 |