| NPI | 1124391149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX R6712) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 268540-1) |
| 207P00000X Emergency Medicine (Licence: RI MD18318) | |
| 207P00000X Emergency Medicine (Licence: SC 38878) | |
| 207P00000X Emergency Medicine (Licence: TX R6712) | |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2024-06-10 |