| NPI | 1477617298 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U0800)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 95-00987)  | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX U0800)  | |
| Enumeration Date | 2006-12-19 | 
| Last Update Date | 2024-07-08 |