| NPI | 1083920888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R6459) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD35917) |
| 207P00000X Emergency Medicine (Licence: TX R6459) | |
| 208M00000X Hospitalist (Licence: OK 29802) | |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2021-03-11 |