| NPI | 1932442787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY MD-45719) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-45719) |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2022-12-16 |