| NPI | 1457325326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX R7827) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NM MD2006-0593) |
| 208000000X Pediatrics (Licence: MN 45069) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-08-19 |