NPI | 1508824467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: DE C1-0007844) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 7632A) |
Enumeration Date | 2006-05-02 |
Last Update Date | 2016-12-08 |