| NPI | 1093886400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX N4497) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 211107) |
| 208000000X Pediatrics (Licence: NY 211107) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 211107) | |
| 208000000X Pediatrics (Licence: TX N4497) | |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX N4497) | |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2011-10-04 |