NPI | 1811901937 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 26439) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 24639) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2013-10-04 |