| NPI | 1760589303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M0631) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M0631) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2024-01-02 |