NPI | 1295723674 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 43909) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L2289) |
Enumeration Date | 2005-10-11 |
Last Update Date | 2021-05-13 |