NPI | 1003044199 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 068028) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL31801) |
Enumeration Date | 2009-06-26 |
Last Update Date | 2020-11-11 |