| NPI | 1932337326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 280310) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 51156) |
| 208000000X Pediatrics (Licence: CT 051156) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2020-03-09 |