NPI | 1871537621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H4460) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX H4460) |
2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: TX H4460) | |
Enumeration Date | 2006-06-15 |
Last Update Date | 2019-12-06 |