| NPI | 1407857725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N0420) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 026653) |
| 207P00000X Emergency Medicine (Licence: TX N0420) | |
| 207R00000X Internal Medicine (Licence: LA 026653) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2010-08-25 |