NPI | 1740527621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: VA 0102203880) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102203880) |
Enumeration Date | 2013-01-11 |
Last Update Date | 2024-07-15 |