| NPI | 1780002261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 9560104-1205) |
| Additional Taxonomies | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: UT 9560104-1205) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2021-11-03 |