NPI | 1275559080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-10129) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MR-0865) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2014-09-26 |