NPI | 1275755688 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 28382) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L-2791) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2022-12-20 |