NPI | 1477946762 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16846) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101021914) |
Enumeration Date | 2015-03-10 |
Last Update Date | 2021-03-29 |