NPI | 1982658597 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M6006) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M6006) |
207P00000X Emergency Medicine (Licence: NM MD2005-0815) | |
207Q00000X Family Medicine (Licence: NM MD2005-0815) | |
Enumeration Date | 2006-05-19 |
Last Update Date | 2007-11-07 |