| NPI | 1376599209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K 9973) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM 99-1) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2016-06-04 |