| NPI | 1235367368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q1097) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q1097) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2014-11-20 |