| NPI | 1285619197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA 25291) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX J3571) |
| 207R00000X Internal Medicine (Licence: WA 25291) | |
| 207R00000X Internal Medicine (Licence: TX J3571) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2007-12-13 |