| NPI | 1184736597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: TX L0231) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L0231) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-07-29 |