NPI | 1285693358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 11635) |
Additional Taxonomies | 174400000X Specialist (Licence: AZ 11635) |
Enumeration Date | 2006-03-18 |
Last Update Date | 2008-04-24 |