| NPI | 1992744593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TX l2900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX l2900) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2015-09-28 |