NPI | 1396078143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q1958) |
Additional Taxonomies | 208D00000X General Practice (Licence: TX Q1958) |
Enumeration Date | 2009-09-11 |
Last Update Date | 2022-07-21 |