| NPI | 1447696505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R0756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT014997) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2024-10-17 |