NPI | 1477539153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M6457) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M6457) |
Enumeration Date | 2005-12-15 |
Last Update Date | 2024-12-05 |