| NPI | 1114337540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R3440) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10050686) |
| 207R00000X Internal Medicine (Licence: TX BP10050686) | |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2017-10-19 |