NPI | 1407843238 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9901189) |
Additional Taxonomies | 208D00000X General Practice (Licence: NC 9901189) |
Enumeration Date | 2005-10-06 |
Last Update Date | 2024-07-15 |