NPI | 1194711945 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A67618) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A67618) |
Enumeration Date | 2005-09-26 |
Last Update Date | 2021-10-15 |