| NPI | 1982065546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S5010) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TX S5010) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2020-10-16 |