NPI | 1447218318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL DO-757) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO28819) |
Enumeration Date | 2006-05-02 |
Last Update Date | 2021-03-24 |