| NPI | 1982863270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V6101) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01068533A) |
| 208000000X Pediatrics (Licence: SC 39280) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: SC 39280) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2025-02-11 |