| NPI | 1871539965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M3633) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX M3633) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2023-03-07 |