| NPI | 1992738967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 97579) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX H8942) |
| 207R00000X Internal Medicine (Licence: TX H8942) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2025-08-01 |