| NPI | 1386606721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M3815) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2005-0515) |
| 207P00000X Emergency Medicine (Licence: TX M3815) | |
| 207Q00000X Family Medicine (Licence: NM MD2005-0515) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2018-12-31 |