| NPI | 1427163955 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K0435) | 
| Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine (Licence: TX K0435) | 
| Enumeration Date | 2006-08-21 | 
| Last Update Date | 2023-11-16 |