| NPI | 1306284211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q7897) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 190717) |
| 207Q00000X Family Medicine (Licence: NC 2014-02041) | |
| 207Q00000X Family Medicine (Licence: TX Q7897) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2023-12-29 |