| NPI | 1386823672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX N4058) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N4058) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2015-08-17 |