| NPI | 1841497393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q0602) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 20583) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2020-02-03 |