Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G6386 | TX |
NPI | 1679532576 |
---|---|
Provider Name | Mr. Michael Edward Ruff |
First Address | Dallas, TX 75231 |
Second Address | Dallas, TX 75231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C21404 | (02) |