| NPI | 1225085418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q4396) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 36890) |
| 207Q00000X Family Medicine (Licence: IA R7521) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-03-23 |