| NPI | 1205127305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q7153) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: DE c1-0010261) | |
| 207P00000X Emergency Medicine (Licence: DE c1-0010261) | |
| 207R00000X Internal Medicine (Licence: TX Q7153) | |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2016-06-24 |