| NPI | 1598734527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX E6082) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX E6082) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2012-03-26 |