NPI | 1306801634 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.024152) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 024152) |
Enumeration Date | 2006-04-19 |
Last Update Date | 2016-09-17 |