| NPI | 1831112598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K0503) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX K0503) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2010-12-21 |