NPI | 1033107164 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 026766) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 00017943) |
Enumeration Date | 2005-10-12 |
Last Update Date | 2014-04-01 |