| NPI | 1770544389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K9653) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX K9653) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX K8653) | |
| 209800000X Legal Medicine (Licence: TX K9653) | |
| 207Q00000X Family Medicine (Licence: IL 036.131054) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: IL 036.131054) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: IL 036.131054) | |
| 209800000X Legal Medicine (Licence: IL 036.131054) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2015-06-24 |