| NPI | 1578786638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2477) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01064066A) |
| 207Q00000X Family Medicine (Licence: TX N2477) | |
| 207Q00000X Family Medicine (Licence: LA MD.201939) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2023-12-28 |