| NPI | 1740718600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R9080) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10061106) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2023-11-08 |