| NPI | 1356676878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N9997) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125052986) |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: TX N9997) | |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2022-02-08 |