| NPI | 1356634315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R2578) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX R2578) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2020-07-07 |