NPI | 1336658921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 18604) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A151782) |
Enumeration Date | 2017-09-26 |
Last Update Date | 2019-03-14 |