| NPI | 1669674230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: AZ 006175) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N3351) |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: TX N3351) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2023-01-26 |