| NPI | 1902873201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX H5484) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX H5484) |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2011-04-14 |