| NPI | 1366882789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX S2877) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS T-2703) |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2020-06-15 |