| NPI | 1477620698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX U7238) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 239158) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2024-01-10 |