| NPI | 1871908178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TX R0246) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: TX R0246) |
| 207Q00000X Family Medicine (Licence: TX BP10051015) | |
| 207Q00000X Family Medicine (Licence: TX R0246) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2024-07-06 |