| NPI | 1003131616 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX R3889) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD454066) | 
| 207P00000X Emergency Medicine (Licence: PA MD454066) | |
| 207P00000X Emergency Medicine (Licence: CA A118857) | |
| 207P00000X Emergency Medicine (Licence: TX R3889) | |
| Enumeration Date | 2010-04-07 | 
| Last Update Date | 2018-04-12 |