| NPI | 1023336211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R4881) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01072353A) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2024-10-28 |