| NPI | 1568561744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M5878) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M5878) |
| 207P00000X Emergency Medicine (Licence: MA 229513) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2024-07-15 |