| NPI | 1538524723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX 583150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q9792) |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2016-11-18 |