| NPI | 1831171495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K5113) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 308232) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: VA 0101268744) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NC 2019-02235) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2024-09-27 |