NPI | 1053351999 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 28569) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 046146) |
Enumeration Date | 2006-06-08 |
Last Update Date | 2024-05-23 |