NPI | 1528258084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N7079) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N7079) |
207Q00000X Family Medicine (Licence: OK 25853) | |
Enumeration Date | 2007-07-30 |
Last Update Date | 2012-07-06 |