NPI | 1760707608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0052360) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.131305) |
Enumeration Date | 2010-04-04 |
Last Update Date | 2022-02-04 |