NPI | 1396715231 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 025352) |
Additional Taxonomies | 174400000X Specialist (Licence: CT 025352) |
174400000X Specialist (Licence: CT 000613) | |
Enumeration Date | 2006-01-24 |
Last Update Date | 2010-07-13 |