| NPI | 1639179690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX J8988) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX j8988) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2025-08-21 |