NPI | 1891762753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N4712) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 36040) |
Enumeration Date | 2006-03-01 |
Last Update Date | 2023-02-21 |