| NPI | 1447297239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX K2644) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ND 10101) |
| 207Q00000X Family Medicine (Licence: ND 10101) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2022-06-14 |