| NPI | 1619911385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX K3262) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX K3262) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-06-22 |