NPI | 1285764399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101241936) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101241936) |
Enumeration Date | 2007-03-07 |
Last Update Date | 2020-01-13 |