NPI | 1447837166 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID 0-1993) |
Additional Taxonomies | 208D00000X General Practice (Licence: NV DO3477) |
Enumeration Date | 2021-03-27 |
Last Update Date | 2024-08-23 |