NPI | 1417268186 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 4178) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD.32855) |
Enumeration Date | 2010-06-28 |
Last Update Date | 2018-12-12 |