| NPI | 1881709517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX J7313) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX J7313) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: TX J7313) | |
| 207P00000X Emergency Medicine (Licence: TX J7313) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: TX J7313) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX J7313) | |
| 208M00000X Hospitalist (Licence: TX J7313) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TX J7313) | |
| 209800000X Legal Medicine (Licence: TX J7313) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX J7313) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX J7313) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2013-09-09 |