| NPI | 1689092017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: DC DO210012382) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 305458) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-06-21 |