| NPI | 1366748048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME122655) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 265795) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX P7879) | |
| 208000000X Pediatrics (Licence: TX P7879) | |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2026-03-23 |