| NPI | 1598328858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U2741) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11438) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2023-10-23 |