| NPI | 1235230574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX J2743) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX J2743) |
| 208000000X Pediatrics (Licence: TX J2742) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2011-02-28 |