| NPI | 1780879643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N8863) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS T-2035) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX N8863) | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2020-12-07 |