NPI | 1003007048 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 37515) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0066324) |
Enumeration Date | 2007-08-06 |
Last Update Date | 2017-01-26 |