| NPI | 1285697979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX J1830) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX J1830) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2020-10-26 |