NPI | 1649247313 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD600004584) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI 13665) |
Enumeration Date | 2006-03-02 |
Last Update Date | 2025-08-27 |