NPI | 1831272772 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-11134) |
Additional Taxonomies | 173000000X Legal Medicine (Licence: WA MD00034372) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2012-12-03 |