| NPI | 1851329932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K9942) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX K9942) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX K9942) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2013-12-20 |