NPI | 1396725339 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MD D37378) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D37378) |
Enumeration Date | 2006-01-17 |
Last Update Date | 2023-12-08 |