NPI | 1831165653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: TX K9922) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 3389) |
207R00000X Internal Medicine (Licence: TX K9922) | |
Enumeration Date | 2006-02-23 |
Last Update Date | 2020-07-20 |