| NPI | 1831165653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: TX K9922) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 3389) |
| 207R00000X Internal Medicine (Licence: TX K9922) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2020-07-20 |