| NPI | 1710970439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 208740) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 208740) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2009-08-19 |