NPI | 1225079825 |
---|---|
Other Name | J LARRY BLACK |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 8543) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 11410) |
207P00000X Emergency Medicine (Licence: MS 8543) | |
Enumeration Date | 2006-06-08 |
Last Update Date | 2016-12-20 |