NPI | 1841497393 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q0602) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 20583) |
Enumeration Date | 2007-06-28 |
Last Update Date | 2020-02-03 |