| NPI | 1467491100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX P0844) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 047475) |
| 207P00000X Emergency Medicine (Licence: GA 047475) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2022-05-05 |