NPI | 1235101676 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C10005740) |
Additional Taxonomies | 208D00000X General Practice (Licence: DE CI0005740) |
Enumeration Date | 2006-02-01 |
Last Update Date | 2015-05-18 |