NPI | 1235240110 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 374682-1205) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 374682-1205) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2024-05-08 |