NPI | 1750418828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 451) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NV 451) |
Enumeration Date | 2007-02-27 |
Last Update Date | 2018-10-10 |