NPI | 1669575981 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 21482) |
Additional Taxonomies | 208D00000X General Practice (Licence: KY 21482) |
Enumeration Date | 2006-09-06 |
Last Update Date | 2023-05-09 |