| NPI | 1730306242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 162957) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 162957) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2018-03-17 |