NPI | 1447298385 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R7C61) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 05-19466) |
Enumeration Date | 2006-06-03 |
Last Update Date | 2009-11-03 |