| NPI | 1912138819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX U9752) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: LA 303238) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CA C192895) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2024-03-29 |