NPI | 1427286038 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036144530) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 45065) |
Enumeration Date | 2009-06-23 |
Last Update Date | 2018-05-10 |