NPI | 1245281666 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 14617) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A93520) |
Enumeration Date | 2006-05-12 |
Last Update Date | 2021-09-21 |