NPI | 1417986316 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 42892) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 42892-20) |
Enumeration Date | 2006-07-02 |
Last Update Date | 2022-08-12 |