| NPI | 1447281142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K1038) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX K1038) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2022-07-21 |