| NPI | 1457567620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N1307) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N1307) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2016-05-11 |