| NPI | 1578982609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX S5815) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S5815) |
| 207P00000X Emergency Medicine (Licence: NC 2018-01001) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2018-01001) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2021-07-21 |