| NPI | 1427305242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C175515) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q3472) |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2024-05-08 |