NPI | 1477614998 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D58436) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD33497) |
207Q00000X Family Medicine (Licence: VA 0101232466) | |
Enumeration Date | 2006-12-12 |
Last Update Date | 2007-07-08 |