| NPI | 1801871603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q1352) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 154708) |
| 207R00000X Internal Medicine (Licence: NY 154708) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2019-12-31 |