NPI | 1386683548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX G0906) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX G0906) |
Enumeration Date | 2006-06-05 |
Last Update Date | 2015-04-01 |