NPI | 1336450360 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036074355) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02001948A) |
207Q00000X Family Medicine (Licence: CA 20A8254) | |
Enumeration Date | 2010-06-24 |
Last Update Date | 2010-06-24 |