NPI | 1326087263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 43670) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD21044) |
207Q00000X Family Medicine (Licence: TN 67415) | |
Enumeration Date | 2006-06-06 |
Last Update Date | 2024-10-25 |