Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 014873 | CA |
NPI | 1114004660 |
---|---|
Provider Name | David Bailey Gifford |
First Address | Fort Hood, TX 76544 |
Second Address | Fort Hood, TX 76544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |