| NPI | 1306922356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L2227) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX L2227) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX L2227) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-05-26 |