NPI | 1295848331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N9339) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP00914) |
Enumeration Date | 2006-08-15 |
Last Update Date | 2012-01-27 |