| NPI | 1427257179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2944) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX N2944) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2024-08-15 |