| NPI | 1356389027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M3975) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 13244R) |
| 207P00000X Emergency Medicine (Licence: TX M3975) | |
| 207R00000X Internal Medicine (Licence: LA 13244r) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2020-12-04 |