| NPI | 1932411998 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX Q7450)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2013012532)  | 
| 208000000X Pediatrics (Licence: TX Q7450)  | |
| Enumeration Date | 2010-07-07 | 
| Last Update Date | 2018-07-10 |