| NPI | 1184690133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 26699) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX H0762) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2023-06-30 |