| 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 |