| NPI | 1932355047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 247862) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08065700) |
| 207P00000X Emergency Medicine (Licence: CA A118090) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA08065700) | |
| 207P00000X Emergency Medicine (Licence: TX P3285) | |
| 208000000X Pediatrics (Licence: NY 247862) | |
| 208000000X Pediatrics (Licence: CA A118090) | |
| 208000000X Pediatrics (Licence: TX P3285) | |
| Enumeration Date | 2008-08-09 |
| Last Update Date | 2019-02-12 |