| NPI | 1912161530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 247895) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 247895) |
| Enumeration Date | 2008-07-13 |
| Last Update Date | 2021-01-18 |