NPI | 1306051677 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 30952) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E5608) |
Enumeration Date | 2007-05-11 |
Last Update Date | 2016-06-17 |