| NPI | 1790190296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX S0067) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S0067) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX S0067) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2024-02-07 |