NPI | 1154367811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 51478-020) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 044708) |
Enumeration Date | 2006-06-21 |
Last Update Date | 2010-12-22 |