NPI | 1215902275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0086890) |
Additional Taxonomies | 208D00000X General Practice (Licence: DE CI0003526) |
Enumeration Date | 2006-02-22 |
Last Update Date | 2022-02-16 |