NPI | 1083616916 |
---|---|
Former Name | BRADLEY NEAL SHIPMAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX K2175) |
Additional Taxonomies | 174400000X Specialist (Licence: TX k2175) |
Enumeration Date | 2005-08-11 |
Last Update Date | 2019-12-16 |