NPI | 1720474240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R6121) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R6121) |
Enumeration Date | 2015-04-10 |
Last Update Date | 2019-08-22 |