| NPI | 1124306170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX BP10048794) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX BP10048794) | |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2014-06-06 |