| NPI | 1508154543 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4880) | 
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: LA 307102) | 
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: AZ 008714) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NM DO2021-0022) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MT 104072) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: OR DO200808) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA 20658) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: AK 126216) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: UT 12603369-1204) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CO CDR.0000536) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: WA OP61036685) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NV CL0088) | |
| Enumeration Date | 2011-07-12 | 
| Last Update Date | 2023-06-22 |