NPI | 1427439694 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0072394) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 22166) |
Enumeration Date | 2015-06-14 |
Last Update Date | 2024-05-21 |