| NPI | 1811518608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TN 73528) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP1709536) |
| 207P00000X Emergency Medicine (Licence: TN 73528) | |
| Enumeration Date | 2020-05-03 |
| Last Update Date | 2025-07-11 |