| NPI | 1942305941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2180) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N2180) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2019-08-29 |