NPI | 1578052882 |
---|---|
Other Name | T. ALEX POLSTON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61161867) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD.61161867) |
Enumeration Date | 2018-05-02 |
Last Update Date | 2021-11-10 |