| NPI | 1447286539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2014-0015) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX K4375) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2020-03-09 |