| NPI | 1528170081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX m4652) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M4652) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX M4652) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-11-17 |