| NPI | 1467452649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX L4890) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX L4890) |
| 207Q00000X Family Medicine (Licence: TX L4890) | |
| 207QA0401X Family Medicine Addiction Medicine (Licence: TX L4890) | |
| 207QA0505X Family Medicine Adult Medicine (Licence: TX L4890) | |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: TX L4890) | |
| 207R00000X Internal Medicine (Licence: TX L4890) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2016-02-01 |