NPI | 1013229236 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-43548) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 56793) |
Enumeration Date | 2010-07-02 |
Last Update Date | 2024-01-11 |