| NPI | 1548551427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P9254) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX P9254) |
| 207P00000X Emergency Medicine (Licence: TX P9254) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2014-09-22 |