NPI | 1295828127 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C20004996) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C2-0004996) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2010-12-22 |