| NPI | 1184020786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX S4359) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME134797) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME134797) | |
| Enumeration Date | 2014-11-08 |
| Last Update Date | 2020-06-29 |