NPI | 1225092257 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 11741) |
Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: SC 11741) |
Enumeration Date | 2006-04-14 |
Last Update Date | 2017-02-02 |