| NPI | 1285845743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P0890) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: TX P0890) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2023-12-12 |