NPI | 1235107657 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M3003) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M3003) |
Enumeration Date | 2006-03-10 |
Last Update Date | 2010-09-23 |