| NPI | 1285989103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P8188) |
| Additional Taxonomies | 207ZC0006X Pathology, Clinical Pathology (Licence: TX P8188) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2016-08-15 |