| NPI | 1881798379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: TX Q2049) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2006027561) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2019-09-04 |