| NPI | 1902253842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R6665) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10055390) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2019-06-25 |