| NPI | 1568477339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX L2943) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L2943) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2024-07-19 |