NPI | 1356333561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 13931) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD013931) |
Enumeration Date | 2005-08-16 |
Last Update Date | 2013-04-17 |