| NPI | 1568856813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 294912-1) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 294912) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2023-09-16 |