NPI | 1831267244 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0053902) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD039774) |
207Q00000X Family Medicine (Licence: VA 0101230789) | |
Enumeration Date | 2006-12-01 |
Last Update Date | 2012-12-06 |