| NPI | 1669444592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX G6723) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX g6723) |
| Enumeration Date | 2006-02-04 |
| Last Update Date | 2014-02-04 |