| NPI | 1639433485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX Q1574) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PB10043190) |
| 207Q00000X Family Medicine (Licence: TX Q1574) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2023-11-14 |