NPI | 1114945433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 24811) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME 012569) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2024-02-15 |