| NPI | 1063593382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 8588717-1205) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: UT 8588717-1205) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2023-08-21 |