NPI | 1386936086 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: MN 23146) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 23146) |
Enumeration Date | 2011-05-12 |
Last Update Date | 2011-05-12 |