NPI | 1407806151 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G161976) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD.07342R) |
Enumeration Date | 2006-05-12 |
Last Update Date | 2024-09-30 |