| NPI | 1134567415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U5897) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TX U5897) |
| 208000000X Pediatrics (Licence: TX U5897) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2026-01-07 |