| NPI | 1942268255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX F2101) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX F2101) |
| 207Q00000X Family Medicine (Licence: TX F2101) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: TX F2101) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2008-03-27 |