| NPI | 1023246774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q1478) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301093749) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2023-03-27 |