NPI | 1437258829 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0044823) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME44823) |
Enumeration Date | 2006-09-21 |
Last Update Date | 2024-06-04 |