| NPI | 1205808318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N9394) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N9394) |
| 207R00000X Internal Medicine (Licence: IA 32077) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2020-03-09 |