| NPI | 1538549175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R0882) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R0882) |
| 207Q00000X Family Medicine (Licence: TX BP10053884) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2023-12-20 |