| NPI | 1619269826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX R3829) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX R3829) |
| 208D00000X General Practice (Licence: VA 0101252571) | |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2023-10-06 |