| NPI | 1538176920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 231024) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 231024) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2018-10-03 |