NPI | 1225085418 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q4396) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 36890) |
207Q00000X Family Medicine (Licence: IA R7521) | |
Enumeration Date | 2006-05-31 |
Last Update Date | 2020-03-23 |