NPI | 1164411013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX F4113) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX F4113) |
Enumeration Date | 2005-10-13 |
Last Update Date | 2019-11-13 |