| NPI | 1881868511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 293741) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 293741) |
| 282NC2000X General Acute Care Hospital, Children | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2023-05-10 |