NPI | 1083909857 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U6831) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P5148) |
207Q00000X Family Medicine (Licence: NM RS2012-0325) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-06-09 |
Last Update Date | 2024-11-04 |