NPI | 1962428482 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F6941) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX F6941) |
Enumeration Date | 2006-07-15 |
Last Update Date | 2009-08-25 |