NPI | 1013221969 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2011-02222) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 49044) |
207Q00000X Family Medicine (Licence: LA 342642) | |
207Q00000X Family Medicine (Licence: MS 33650) | |
207Q00000X Family Medicine (Licence: IL 036170828) | |
207Q00000X Family Medicine (Licence: TX Q1936) | |
Enumeration Date | 2010-08-03 |
Last Update Date | 2025-06-17 |