| NPI | 1326064767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX J9231) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: TX J9231) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2015-03-25 |