NPI | 1598931982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301060888) |
Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MI 4301060888) |
Enumeration Date | 2008-05-05 |
Last Update Date | 2008-05-05 |