NPI | 1528074721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX E2751) |
Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: TX E2751) |
Enumeration Date | 2006-07-31 |
Last Update Date | 2017-01-19 |