NPI | 1437600624 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S3984) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 327881) |
Enumeration Date | 2016-10-22 |
Last Update Date | 2024-02-08 |