| NPI | 1689684904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX E8746) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX E8746) |
| 207P00000X Emergency Medicine (Licence: TX E8746) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX E8746) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-07-19 |