| NPI | 1467847608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U4150) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: TX U4150) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX U4150) | |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2026-05-14 |