NPI | 1194771840 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-107472) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 34196) |
Enumeration Date | 2006-05-25 |
Last Update Date | 2015-06-26 |