NPI | 1598997819 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.30550) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L3084R) |
Enumeration Date | 2009-08-20 |
Last Update Date | 2017-10-19 |