NPI | 1467959635 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S7730) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10064798) |
Enumeration Date | 2018-04-12 |
Last Update Date | 2021-06-04 |