| NPI | 1629282496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: TX R4957) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2012004798) |
| 208000000X Pediatrics (Licence: KS 04-35493) | |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: MS 23806) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2023-02-14 |