NPI | 1720492242 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.36828) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R3734) |
207Q00000X Family Medicine (Licence: TX BP10050704) | |
Enumeration Date | 2014-06-12 |
Last Update Date | 2019-06-05 |