| NPI | 1457746364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R8832) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R8832) |
| 208000000X Pediatrics (Licence: NE 29850) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2025-01-27 |