| NPI | 1770015885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX S8825) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX s8825) |
| 207QA0000X Family Medicine, Adolescent Medicine (Licence: TX S8825) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX S8825) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: TX S8825) | |
| 207R00000X Internal Medicine (Licence: NV 19837) | |
| 208000000X Pediatrics (Licence: TX S8825) | |
| 208M00000X Hospitalist (Licence: NV 19837) | |
| 208M00000X Hospitalist (Licence: CA A170976) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2022-12-19 |