NPI | 1437642170 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2021-02151) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-09531) |
Enumeration Date | 2018-06-07 |
Last Update Date | 2021-10-26 |