| NPI | 1144667627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S3508) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD33629) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2024-02-01 |