NPI | 1093921066 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD202835) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10025406) |
Enumeration Date | 2007-05-15 |
Last Update Date | 2009-07-28 |