| NPI | 1306342431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S6243) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10063117) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2024-06-04 |