NPI | 1700014271 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 7212) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 5821) |
Enumeration Date | 2009-06-23 |
Last Update Date | 2024-04-09 |