NPI | 1710189097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: TX N3749) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N3749) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2007-05-31 |
Last Update Date | 2024-09-17 |