| NPI | 1861497208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX F8676) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX F8676) |
| 207P00000X Emergency Medicine (Licence: TX F8676) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2024-05-29 |