| NPI | 1194766311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 340027) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K2273) |
| 207P00000X Emergency Medicine (Licence: TX K2273) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-02-14 |