| NPI | 1508810375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F8573) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR C4734) |
| 208000000X Pediatrics (Licence: AR C4734) | |
| 207Q00000X Family Medicine (Licence: AR C4734) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2016-09-06 |