| NPI | 1285629220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX TXJ1574) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX J1574) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2016-03-25 |