| NPI | 1902802697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F6654) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX F6654) |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: TX F6654) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX F6654) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2022-03-31 |