NPI | 1992010433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q2833) |
Additional Taxonomies | 208600000X Surgery (Licence: NY AC4187868124) |
Enumeration Date | 2010-08-09 |
Last Update Date | 2015-11-25 |