NPI | 1205198272 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q1978) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q1978) |
Enumeration Date | 2012-06-14 |
Last Update Date | 2015-06-25 |