| NPI | 1487680211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 30370) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.065321) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX U7312) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TN MD0000030370) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2025-05-06 |