| NPI | 1659660314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-9247) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P3996) |
| 207P00000X Emergency Medicine (Licence: AR E-9247) | |
| 207Q00000X Family Medicine (Licence: TX P3996) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: AR E-9247) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2021-12-21 |