| NPI | 1043460132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX P6223) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P6223) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 57) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX P6223) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35-095169) | |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2021-04-21 |