| NPI | 1649267295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX H2988) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H2988) |
| 207R00000X Internal Medicine (Licence: TX H2988) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2022-12-02 |