NPI | 1306951504 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 294180-1205) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 95-294180-1205) |
Enumeration Date | 2006-08-20 |
Last Update Date | 2023-11-27 |