| NPI | 1942435060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101267329) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D72130) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX Q2010) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2020-09-22 |