| NPI | 1336308113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N1462) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N1462) |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX N1462) | |
| 207R00000X Internal Medicine (Licence: NY 248715) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2013-01-10 |