NPI | 1295172856 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T7026) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A129556) |
Enumeration Date | 2013-05-22 |
Last Update Date | 2024-11-06 |