| NPI | 1528219573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 42473) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 42473) |
| 207R00000X Internal Medicine (Licence: TX P4218) | |
| 207P00000X Emergency Medicine (Licence: TX P4218) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2015-04-16 |