NPI | 1588718340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 4887) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 4887) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2022-05-23 |