NPI | 1467491969 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L4267) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L4267) |
Enumeration Date | 2006-06-06 |
Last Update Date | 2012-10-29 |