| NPI | 1609870161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K8099) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX K8099) |
| Enumeration Date | 2005-06-11 |
| Last Update Date | 2024-09-25 |