| NPI | 1437296530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 5324) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX H2829) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2015-04-06 |