| NPI | 1003951245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: TX N0321) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX N0321) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2018-10-11 |