| NPI | 1346355344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2008-0652) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N8063) |
| 207P00000X Emergency Medicine (Licence: AR E-4209) | |
| 207Q00000X Family Medicine (Licence: TX N8063) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2023-02-16 |