| NPI | 1891784377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX H9459) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX H9459) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX H9459) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2021-08-25 |