NPI | 1376529883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME42961) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME42961) |
Enumeration Date | 2005-12-16 |
Last Update Date | 2024-02-21 |