| NPI | 1316076482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX E8260) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX E8260) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2014-02-12 |