| NPI | 1568487064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MA 60055) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 164290) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NV DO3224) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2024-10-29 |