| NPI | 1528323797 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX s2175) | 
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TN 55016) | 
| 207P00000X Emergency Medicine (Licence: TX S2175) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208000000X Pediatrics (Licence: WI 64474-20) | |
| 208000000X Pediatrics (Licence: LA MD.207568) | |
| Enumeration Date | 2012-07-12 | 
| Last Update Date | 2024-03-19 |