NPI | 1871908178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TX R0246) |
Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: TX R0246) |
207Q00000X Family Medicine (Licence: TX BP10051015) | |
207Q00000X Family Medicine (Licence: TX R0246) | |
Enumeration Date | 2014-06-25 |
Last Update Date | 2024-07-06 |