| NPI | 1710207147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: DC MD043956) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 271883) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 271883) | |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2016-06-14 |