| NPI | 1205220423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S7018) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 291261) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX S7018) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 291261) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2021-07-22 |