NPI | 1730453739 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P5151) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207Q00000X Family Medicine (Licence: TX P5151) | |
Enumeration Date | 2012-03-08 |
Last Update Date | 2015-07-09 |