| NPI | 1811216542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P8275) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10037110) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2017-08-17 |