NPI | 1093886400 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX N4497) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 211107) |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 211107) | |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX N4497) | |
207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 211107) | |
207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX N4497) | |
Enumeration Date | 2006-11-10 |
Last Update Date | 2024-11-16 |