NPI | 1790949667 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301064984) |
Additional Taxonomies | 173000000X Legal Medicine (Licence: MI 4301064984) |
Enumeration Date | 2008-07-10 |
Last Update Date | 2023-10-12 |