| NPI | 1477084366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX U0121) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.138703) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-03-07 |