| NPI | 1174796254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N4774) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 20551) |
| 207Q00000X Family Medicine (Licence: GA 001637) | |
| 207Q00000X Family Medicine (Licence: IN 01064214A) | |
| 208M00000X Hospitalist (Licence: IN 01064214A) | |
| 207Q00000X Family Medicine (Licence: TX N4774) | |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2012-11-30 |