NPI | 1073952537 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1360) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2013018129) |
Enumeration Date | 2013-06-18 |
Last Update Date | 2024-07-19 |