NPI | 1598774697 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 009601390) |
Additional Taxonomies | 208D00000X General Practice (Licence: NC 9601390) |
Enumeration Date | 2006-08-07 |
Last Update Date | 2025-02-03 |