| NPI | 1164688966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX N1971) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N1971) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2011-05-04 |