| NPI | 1902268550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S5721) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 56635) |
| 207P00000X Emergency Medicine (Licence: KY 51712) | |
| 207P00000X Emergency Medicine (Licence: MO 2020010832) | |
| 207Q00000X Family Medicine (Licence: TN 56635) | |
| 207R00000X Internal Medicine (Licence: KY 51712) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX S5721) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-01-19 |