| NPI | 1699118307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX R0452) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R0452) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2023-02-01 |