NPI | 1366588535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D80061) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2006-00361) |
207Q00000X Family Medicine (Licence: DC MD036513) | |
Enumeration Date | 2007-01-29 |
Last Update Date | 2018-03-17 |