| NPI | 1902842172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N4861) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MS 18470) |
| 207P00000X Emergency Medicine (Licence: TX N4861) | |
| 207RA0000X Internal Medicine, Adolescent Medicine (Licence: TX n4861) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2012-05-18 |