NPI | 1578712311 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N1027) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N1027) |
Enumeration Date | 2008-09-17 |
Last Update Date | 2013-09-23 |