NPI | 1366554743 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C7608) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR C7658) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2012-11-01 |