| NPI | 1982189320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 318048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY P13056) |
| 208000000X Pediatrics (Licence: NY 318048) | |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2023-05-05 |