| NPI | 1578583373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 11656) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX F8465) |
| 207Q00000X Family Medicine (Licence: TX F8465) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX F8465) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-04-27 |