NPI | 1023010592 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA L022840) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036167418) |
207Q00000X Family Medicine (Licence: IA MD-50271) | |
Enumeration Date | 2005-08-12 |
Last Update Date | 2023-11-16 |