| NPI | 1013968064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX K1769) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX K1769) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2016-07-21 |