| NPI | 1366556441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4927) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A91788) |
| 207P00000X Emergency Medicine (Licence: CA A91788) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2013-08-15 |