| NPI | 1679573984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX U9636) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TN 31672) |
| 208000000X Pediatrics (Licence: TX U9636) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2024-03-05 |