| NPI | 1063455483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: DE C10010378) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX G5250) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX G5250) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX G5250) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-07-25 |