| NPI | 1922110113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX N0935) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX FTL42125) |
| 208000000X Pediatrics (Licence: GA 051976) | |
| 208000000X Pediatrics (Licence: TX N0935) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-10-06 |