| NPI | 1568759207 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S3426) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 33453) | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX S3426) | |
| 207V00000X Obstetrics & Gynecology (Licence: SC LL33848) | |
| Enumeration Date | 2011-07-01 | 
| Last Update Date | 2021-06-29 |