| NPI | 1265728513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P0407) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P0407) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2016-06-29 |