| NPI | 1104842137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N5553) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: PA MD446379) |
| 207P00000X Emergency Medicine (Licence: GA 055175) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX N5553) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-01-16 |