| NPI | 1497742647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX TEMP) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00025299) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2011-05-11 |