NPI | 1225028731 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 17427) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 43545) |
Enumeration Date | 2005-10-26 |
Last Update Date | 2022-10-18 |