| NPI | 1881868511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.154025) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08400200) |
| 282NC2000X General Acute Care Hospital Children | |
| 207P00000X Emergency Medicine (Licence: NY 293741) | |
| 208000000X Pediatrics (Licence: NY 293741) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2025-07-30 |