| NPI | 1831551712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S6829) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S6829) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-01-20 |