NPI | 1689707218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 50953-21) |
Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: WI 50953-21) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2024-07-30 |