Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1235508086 |
---|---|
Provider Name | Paul Goldstein |
First Address | El Paso, TX 79912-1738 |
Second Address | El Paso, TX 79912-1738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2015 |
Last Update Date | 23/09/2015 |