NPI | 1174681928 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 56913841205) |
Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: UT 56913841205) |
Enumeration Date | 2006-12-05 |
Last Update Date | 2022-01-25 |