| NPI | 1528871654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM HANSEN Physician 210-997-6801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-01-31 |