| NPI | 1942625421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 275264) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 275264) |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2024-05-14 |