NPI | 1548278633 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A105623) |
Additional Taxonomies | 173000000X Legal Medicine (Licence: TX L9583) |
Enumeration Date | 2006-08-04 |
Last Update Date | 2023-08-28 |