| NPI | 1063477412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX l9773) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX L9773) |
| 207P00000X Emergency Medicine (Licence: TX L9773) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2015-02-20 |