| NPI | 1124425129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S1419) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OK 32195) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2024-10-08 |