NPI | 1396734646 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 3224) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL OS11746) |
Enumeration Date | 2005-10-19 |
Last Update Date | 2023-03-07 |