NPI | 1669577060 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS3779) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS3779) |
Enumeration Date | 2006-09-13 |
Last Update Date | 2011-03-04 |