| NPI | 1770014813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 303012-01) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 303012-01) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2024-06-03 |