| NPI | 1972506442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q0536) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G74917) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2025-03-12 |