NPI | 1053554360 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N3958) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX N3958) |
Enumeration Date | 2009-04-16 |
Last Update Date | 2013-05-21 |