NPI | 1427219567 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD156439) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MR-0995) |
Enumeration Date | 2008-06-20 |
Last Update Date | 2013-01-24 |