NPI | 1356300271 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R9D28) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MO R9D28) |
Enumeration Date | 2006-03-20 |
Last Update Date | 2007-07-08 |