| NPI | 1528491305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q7526) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10047430) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2018-10-26 |