| NPI | 1760523583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX R9161) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 24000) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2024-09-25 |