| NPI | 1356348635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K6273) |
| Additional Taxonomies | 2279P3800X Respiratory Therapist, Registered, Palliative/Hospice (Licence: TX K6273) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2011-11-01 |