NPI | 1689028425 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NY 300754) |
Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 300754) |
Enumeration Date | 2016-04-18 |
Last Update Date | 2020-03-05 |