| NPI | 1417137894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX P9758) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT187776) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO 2011010511) | |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2019-03-11 |