NPI | 1073755773 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P4430) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102203078) |
207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX P4430) | |
2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX P4430) | |
Enumeration Date | 2009-03-27 |
Last Update Date | 2014-05-29 |