| NPI | 1750885752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 315381) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OS021250) |
| 208000000X Pediatrics (Licence: NY 315381) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2023-08-02 |