NPI | 1386606721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M3815) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2005-0515) |
207P00000X Emergency Medicine (Licence: TX M3815) | |
207Q00000X Family Medicine (Licence: NM MD2005-0515) | |
Enumeration Date | 2006-04-03 |
Last Update Date | 2018-12-31 |