NPI | 1073741732 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 26280) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 2628026) |
Enumeration Date | 2009-07-01 |
Last Update Date | 2020-03-24 |