| NPI | 1598082844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 271713) |
| Additional Taxonomies | 282NC2000X General Acute Care Hospital, Children (Licence: NY 271713) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2023-02-28 |