| NPI | 1134238777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: TX M5467) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M5467) |
| 207P00000X Emergency Medicine (Licence: IA 37441) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX M5467) | |
| 208000000X Pediatrics (Licence: LA MD201010) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2023-05-01 |