| NPI | 1588169106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX U5549) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX U5549) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-07-09 |