| NPI | 1376587832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N1246) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX N1246) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX N1246) | |
| 208000000X Pediatrics (Licence: NJ MA073321) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2014-04-28 |