NPI | 1639144504 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX L2137) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L2137) |
Enumeration Date | 2006-02-22 |
Last Update Date | 2011-08-11 |