NPI | 1770752206 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 1435) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL os5369) |
Enumeration Date | 2008-02-28 |
Last Update Date | 2008-02-28 |