| NPI | 1740266360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX K0305) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX K0305) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2014-02-11 |