NPI | 1063674018 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 45170) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E6346) |
Enumeration Date | 2008-07-01 |
Last Update Date | 2011-09-21 |