NPI | 1760446686 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 1312) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 1312) |
Enumeration Date | 2006-04-17 |
Last Update Date | 2017-08-24 |