| NPI | 1760592216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX E0922) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX E0922) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-05-10 |