| NPI | 1023221413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M7245) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01063441A) |
| 207P00000X Emergency Medicine (Licence: TX M7245) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2014-12-09 |