NPI | 1568782761 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 47144) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125058266) |
Enumeration Date | 2010-06-10 |
Last Update Date | 2016-06-15 |