NPI | 1447332689 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX S5000) |
Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX S5000) |
2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 213458) | |
Enumeration Date | 2006-10-19 |
Last Update Date | 2021-12-03 |