NPI | 1194783472 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: AR E-3967) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-3967) |
207Q00000X Family Medicine (Licence: GA 91108) | |
207Q00000X Family Medicine (Licence: OH 34C.000045) | |
207Q00000X Family Medicine (Licence: TX T2895) | |
207Q00000X Family Medicine (Licence: AR E-3967) | |
Enumeration Date | 2006-05-03 |
Last Update Date | 2025-03-03 |