| NPI | 1083839393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P0001) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 001759) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2024-01-25 |