| NPI | 1346539491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4181) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P4181) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2015-04-24 |