NPI | 1629040407 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 70-208) |
Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NM 70-208) |
Enumeration Date | 2006-02-06 |
Last Update Date | 2007-07-09 |