| NPI | 1952359952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX G8011) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX G8011) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX G8011) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-04-30 |