| NPI | 1699773226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F3714) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX F3714) |
| 208600000X Surgery (Licence: TX F3714) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2024-07-25 |