| NPI | 1093095127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P7803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV ED0108B) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX P7803) | |
| Enumeration Date | 2011-08-20 |
| Last Update Date | 2021-08-11 |