| NPI | 1063778959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX R8457) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX R8457) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2024-10-17 |