| NPI | 1083624068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2186) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N2186) |
| 208000000X Pediatrics (Licence: MA 219807) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2024-09-19 |