| NPI | 1740302561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: TX P6655) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MO 2007004402) |
| 207R00000X Internal Medicine (Licence: TX P6655) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2013-12-31 |