NPI | 1497149884 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 57206) |
Additional Taxonomies | 208D00000X General Practice (Licence: TN 57206) |
Enumeration Date | 2015-03-24 |
Last Update Date | 2024-07-23 |