NPI | 1295979136 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P1441) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 26465) |
Enumeration Date | 2009-04-22 |
Last Update Date | 2024-11-11 |