| NPI | 1487661781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP111090) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX Ap111090) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX AP111090) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX AP111090) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX Ap111090) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX Ap111090) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-02-14 |