| NPI | 1962440875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2018-0202) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N3018) |
| 207R00000X Internal Medicine (Licence: SC 20233) | |
| 207R00000X Internal Medicine (Licence: TX N3018) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2022-09-07 |